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Card Charge Form

In order to use a short code for copying, please acquire an MLibrary Copy Card. They are available at the main circulation desks of the Hatcher, Shapiro, Art, Architecture & Engineering, and Taubman Medical libraries.

Once a card has been acquired, fill out this form, using the UMID of the MLibrary Copy Card you picked up.

Date:

Name:

Uniqname:

Email address:

Department and campus address:

Telephone Number [ten digits]:

ShortCode to be billed [six digits]:

MLibrary Copy Card UMID [eight digits]: (Your shortcode will be billed monthly for all copying charges, at the rate of 6 cents per copy.)

To apply a shortcode to additional cards, please enter the shortcodes and UMIDs of the cards in this box:

Please send me a copy of this message.

Page maintained by nscholtz
Last modified: 05/04/2011